health!St. Elizabeth

Franciscan Health System • FAll 2011

FROM ST. eLiZABeTH HoSPiTAL AND THE OTHER SERVICES OF FRAnCiSCAn HeALTH SYSTeM

See page 15 for our

Calendar of Events

Are you at risk forHeART DiSeASe?

Keep your bones strong

Thinking about JoinT RePLACeMenT?See page 5

In the community

4 Franciscan Health System | Fall 2011

Stop the violenceGroup strives to make Enumclaw, Plateau safer communitiesDuring a meeting earlier this year at St. Elizabeth Hospital, a woman told her story about being shot by a stranger. The assailant, she later learned, had a history of unprovoked violence and was the victim of abuse as a child.

Sadly, stories like this one are all too common. However, a volunteer group, called Linking Civility, Compassion and Kindness (LINCCK), is bringing hope for breaking the cycle of violence. This task force is dedicated to preventing domestic violence in Enumclaw and other communities and has expanded its focus to prevent all types of violence.

“Crimes can be perpetuated through silence or a lack of knowledge about problems and potential solutions,” says Kim Farnes, violence prevention coordinator for Franciscan Health System and a member of LINCCK. “By working together, we can make a positive difference for our community, for our children and for each other.”

LINCCK includes: Franciscan Health System’s St. Elizabeth Hospital in Enumclaw; Plateau Outreach Ministries; Enumclaw Regional Healthcare Foundation; Enumclaw Senior Center; Enumclaw Police Department;

Attorney Tripp Hart; Out of the Ashes; Valley Cities Counseling; and the City of Covington.

LINCCK is already making a difference by promoting activities designed to raise awareness and generate hope.

St. Elizabeth Hospital is among “Most Wired” in nationSt. Elizabeth Hospital is included on the 2011 list of the 25 “Most Wired” small and rural hospitals in the nation for its use of information technology to support quality patient care and achieve operational efficiencies.

The list is compiled by Hospitals & Health Networks magazine.“We are proud to be recognized for meaningful use of information technology

that makes our hospital the best place to heal, the best place to work and the best community health resource,” says St. Elizabeth president Dennis Popp. He also acknowledged Shelly Pricco, director of patient care services at St. Eliza-beth, and Danielle Rogers, the hospital’s clinical systems specialist, for their leadership in implementing new clinical and information technology (IT) systems.

Innovative technologies at St. Elizabeth include electronic medical records and data management protocols; a computerized system for physicians to enter medical orders; bedside barcode scanning that ensures hospitalized patients receive correct medications; and wireless technology that enables physicians, nurses and other caregivers to quickly and quietly communicate regardless of where they are in the state-of-the-art hospital.

Learn more about YOUR hospital! Go to www.NewEnumclawHospital.org.

www.FHShealth.org 5

Osteoarthritis

Enumclaw resident Liz Enger, 65, has been an athlete all her life. She loves to hike, bike and ski. But three years ago, her knee pain got to the point where she was barely able to walk a quarter mile from her home. Liz had osteoarthritis. The cartilage in her knee joint had completely worn away and the bones were rubbing against one another, resulting in debilitating pain.

“Not only was the pain keeping me from doing my favorite outdoor activities, it made everyday tasks feel impossible,” Liz says. She knew she needed to do something about it.

Liz met with David Bishop, MD, an orthopedic surgeon affi liated with St. Elizabeth Hospital, who had performed three prior surgeries on her. “She had suff ered numerous injuries to her knee over the years and replacing the joint was the very best option for resolving the pain,” Dr. Bishop explains.

A solution to joint pain In 2008, Dr. Bishop replaced Liz’s left knee. The recovery went well, but she had also developed osteoarthritis in her right knee that continued to keep her off the trails. “Originally, I was hoping I wouldn’t need to have surgery on the right knee for a while. But the left one went so well I had the second one replaced a year­and­a­half later when Dr. Bishop recommended it,” Liz says.

After the second surgery, Liz worked hard in physical therapy. Four months later she was able to hit the ski slopes again. “I was nervous about getting back on skis,

but I felt better and better as the season went on, and I’m almost completely back to normal now,” she says. “This year I skied until July 19 and had the best winter in a long time. I even skied a run with Dr. Bishop!”

Wide range of orthopedic treatments In addition to performing knee replacement surgeries, Dr. Bishop also does hip replacement surgery at St. Elizabeth. “We use proven technologies that have excellent track records and provide the best outcomes for our patients,” Dr. Bishop says.

Patients are often surprised to learn how quickly they’re sitting or standing after having a knee or a hip replaced.

Today, Liz is grateful to be as active as she likes. “I got my life back,” she says.

Staying active with joint replacement surgery

lifelong athlete gets back in action

David Bishop, MD

Don’t let joint pain sideline you. Learn how to get back in the action by attending a free health talk. Find one near you by calling 888-825-3227 or go to www.FHShealth.org/classes.

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✃

10% off

Either lunch or dinner at the

St. Elizabeth Cornerstone Café

8 Franciscan Health System | Fall 2011

Being a parent isn’t always easy. You want to protect your children and keep them healthy. But it can be diffi cult to know how. Although there are many things you can’t control in life, you can ensure your children are up­to­date on their vaccinations.

“Childhood vaccinations are so important because they protect children from potentially devastating or life­threatening diseases,” explains Tanya Wilke, MD, a family medicine physician with Franciscan Medical Group at Enumclaw Medical Center. “Parents need to know that these diseases still exist in our communities. Delaying or foregoing immunization leaves your child unprotected.”

Dr. Wilke reports that Western Washington has had recent outbreaks of pertussis. Measles has also been more prevalent throughout the country, and each year the infl uenza virus kills more than 40,000 people nationwide.

“In addition to the regular vaccination schedule, try to get children six months and older a fl u shot in October or November. This will help ensure the vaccine is most eff ective at the peak of fl u season,” she advises.

Addressing concernsAlthough vaccinations are easy to administer and can save lives, some parents are still wary of them. Why? False reports have incorrectly linked vaccines to certain health conditions. Others introduce concern about giving too many shots at once.

“It’s wonderful that parents care so much about doing the right thing for their child. However, they don’t need to fear the safety of vaccines,” says Dr. Wilke. “Studies prove there is no link between vaccines and health conditions like autism. And if you prefer, many doctors will work with you to spread out vaccinations over several visits. What’s most important is that the child receives the vaccine.” 

Making it easierTo make shots a little easier, Dr. Wilke suggests feeding babies right after immunization because sucking releases feel­good endorphins that can ease pain. She also recommends talking to older kids about shots before the visit and giving them a special reward, such as going to the park, to look forward to afterwards.

A shot at prevention Protecting your child through vaccination

Your new primary care physician is waiting for you at one of Franciscan Medical Group’s two Enumclaw locations. Get connected today by calling 888-825-3227.

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Pediatric care

St. Elizabeth Hospital’s environmentally friendly design has earned it the LEED (Leadership in Energy and Environmental Design) Silver Certifi cation by the U.S. Green Building Council.

LEED certifi cation of St. Elizabeth Hospital is based on a number of “green” design and construction features that positively impact the hospital and the broader community, such as:• an energy-effi cient mechanical system that does not use ozone-depleting coolants • large, energy-effi cient windows that reduce the need for electric lights

during daylight hours • a robust, ongoing recycling program • landscaping with water-effi cient, native plants that help manage storm

water runoff

Environmental excellence: St. Elizabeth Hospital earns LEED certifi cation

Tanya Wilke, MD

Inflammation

www.FHShealth.org 9

There is growing concern about the debilitating impact of chronic inflammation—now thought to be the root cause of degenerative disorders like arthritis,

obesity, heart disease and cancer. But what exactly is inflammation and why is it so devastating?

Normally, inflammation is our body’s protection system. When we have an injury or exposure to a foreign micro­organism, our body responds to the threat with inflammation and destroys the alien cells and then returns to normal.

Chronic inflammation, takes place when the inflammation doesn’t turn off, and instead of protecting our bodies, continues to attack.

Scientists think chronic inflammation inside the body could play a role in the development of more serious conditions.

Does inflammation matter?Over the years, doctors have learned that cancer often arises at sites of internal inflammation. A study in the Archives of Internal Medicine found that women with higher white blood cell counts—a sign of inflammation— had a greater risk of developing cancer of the breast, colon, lung and uterine lining. Inflammation also tends to go hand­in­hand with heart disease.

Jude Verzosa, MD, an internist with Franciscan Medical Group’s Enumclaw Medical Center, agrees that low­level inflammation is often present in many different chronic conditions, such as type 2 diabetes, heart disease, peripheral arterial disease, stroke and lupus. But, he notes, the jury is still out on whether or

not it actually contributes to the conditions. “We generally look at inflammation to help us determine the course of treatment, not to diagnose disease,” he explains.

Tracking inflammationOne sign of inflammation is C­reactive protein, or CRP, a protein made by the liver. When there’s inflammation in the body, CRP levels rise. Dr. Verzosa explains that doctors may order high­sensitivity CRP tests to check whether some inflammation­related diseases, such as rheumatoid arthritis or lupus, are progressing.

“Overall, studies seem to indicate that people with this type of chronic internal inflammation do worse than those without. So we may treat a condition more aggressively if inflammation is present in an effort to improve long­term outcomes,” Dr. Verzosa says.

Can diet help?Some experts think that what you eat can reduce inflammation in your body. Dr. Verzosa cautions that this depends on the disease you face.

“Will diet play a role in diabetes control? Yes. Heart disease? Certainly —that plus a statin drug,” Dr. Verzosa says. For a rheumatologic condition such as lupus, though, it may not impact the condition, he adds. Your primary care physician will help guide your treatment.

If you are advised by your doctor to make lifestyle changes because of a chronic condition, choosing foods that have been shown to help fight inflam­mation in the body may be a good choice. These include:

• fiber­rich foods such as pears, peas and prunes

• fish• nuts• foods with magnesium, such as soy,

beans and leafy greens Some foods to avoid because they

might add to inflammation are:• red and processed meats• full­fat dairy products• white bread and white rice

Obesity is linked to inflammation.

Shedding pounds has been shown in studies to reduce inflammation and, likewise, the overall risk for cardiovascular disease.

Other strategies that can reduce inflammation are exercising and not smoking. These smart moves also target other risk factors for disease, such as artery­clogging cholesterol, which raises heart risks.

Jude Verzosa, MD

Our health care experts have the answers you’re looking for. Call a Franciscan Medical Group doctor at 888-825-3227 today!

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Inflammation in focusChronic inflammation may play a role in a multitude of health issues

10 Franciscan Health System | Fall 2011

You may view fragility fractures—when bones break because they cannot withstand body weight during a normal daily activity—as a later­life concern. Not so, says orthopedic surgeon Patrick Vaughan, MD, with Tacoma Orthopaedic Surgeons.

“Fractures have their roots in weakened bones, known as osteoporosis. And since bone mass peaks in your 20s, if you’re 35 or older, it’s time to start thinking about preventing this potentially debilitating condition,” Dr. Vaughan explains.

Fortunately, with smart prevention and the help of Franciscan Medical Group physicians, you can stay one step ahead of fractures and live a more active, healthier life, whether you’re 29 or 90.

Are you at high risk for osteoporosis?“Osteoporosis means ‘bones with holes,’ and it is reaching epidemic proportions among American women,” says orthopedic surgeon John Bargren, MD, who practices at The Ortho­paedic Center in Tacoma.

Being female and older increases your risk of developing osteoporosis—though men can develop it, too. Other risks include being Caucasian, being underweight, drinking excessive alcohol or coffee, and smoking.

Primary care physicians start testing an otherwise healthy woman for osteopo­rosis between ages 60 and 65 using the DEXA scan. This painless imaging test compares the density of bones in a

woman’s hip and lower spine against composite scores of healthy women in their 20s—the lower the score, the weaker the bones.

A score of ­2.5 or lower indicates osteoporosis, while ­1.0 to ­2.5 indicates a less severe bone weakening called osteopenia. Both diagnoses warrant attention, with lifestyle change the usual course of treatment for osteopenia. However, the lower the score, the more likely it is that a physician will recommend both lifestyle change and some form of medication therapy.  

The danger of fractures“Fragility fractures usually occur in the hip or spine, though wrists and shoul­ders can also sustain these troubling injuries,” states Dr. Bargren. “Spine fractures may contribute to height loss and spine rounding. Hip fractures require rehabilitation and are more likely to result in loss of independence.”

With the rise in osteoporosis rates, hip fractures are becoming more common, averaging more than 500,000 each year.

Both men and women have a one in five chance of sustaining fragility fractures before age 65. However, after 65, the risk for women increases to a one in two chance. The reason for this change? Menopause. Once estrogen production falls, bone density decreases dramatically. Fortunately, there are preventive measures you can take to help protect your bones.

Start—or keep—exercising“Walk for 30 minutes at least three times weekly as a minimum. This kind of weight­bearing exercise is critical to increasing bone mass,” says Dr. Bargren.

“Other beneficial activities include hiking, jogging, dancing and aerobics—anything that pits your bones against the force of gravity,” he adds. “So while biking or swimming may be great for your heart, make sure you add a weight­bearing activity to your regular fitness routine for your bones.”

Bone up at mealtimeThe Institute of Medicine recommends supplementing with calcium (1,000 mg for premenopausal women and 1,200­1,500 for postmenopausal women) and vitamin D (400­800 international units, or IUs, daily). “Taking vitamin D is extremely important in the Pacific Northwest, where sunshine is at a premium,” notes orthopedic surgeon Joshua Johnston, MD, with Franciscan Orthopedic & Sports Medicine Associates.

A healthy diet can also help your body get the minor minerals it needs for bone­building such as magnesium, manganese and iron. Many physicians recommend leafy green vegetables and other plant­based foods in addition to calcium sources like milk and yogurt.

Practice balanceAccording to the Centers for Disease Control and Prevention (CDC), injuries from home­related falls result in an average of 21 million medical visits and 20,000 deaths each year. They are the

leading cause of injury among adults ages 65 years and older in the US. However, studies show that patients in their 80s and 90s who exercise regularly have improved balance and fewer falls.

Osteoporosis

Fend off fragility fractures Understand your osteoporosis risk to maintain health and quality of life

Patrick Vaughan, MD

John Bargren, MD

Joshua Johnston, MD

www.FHShealth.org 11

If your balance isn’t what it used to be, start slowly. Stand near a support structure, such as a wall or a table so you can catch yourself if necessary. Stand on one leg for five seconds and then do the same with the other leg every day. After a week, repeat the exercises but try to increase the time to 10 seconds. Ulti­mately, you should set a goal of 15 or 20 seconds each day.  

Quit smoking“Many patients in their 30s think the only risk to smoking is lung cancer. They are surprised to learn that smok­ing leads to greater risk for back pain, osteoporosis and results in longer recovery time to heal after injuries,” says Dr. Vaughan. For fractures, longer recoveries can mean more time off your feet, which negatively impacts long­term mobility and heart health, and increases the risk for infection. 

Get screened  As noted, most primary care physicians start screening for osteoporosis between the ages of 60 to 65. You may be

screened as early as 50 if you have any of the following:• family or personal history of

osteoporotic fractures • loss of height, which can indicate

spine strength issues • history of steroid or injectable

birth control use • smoke or drink excessive alcohol

or coffee

If you are female, white and under­weight, and fall into any of the risk factors, early screening is important. 

Understand treatment risksNo medication therapy is without risks. In the past, estrogen therapy was used to help prevent bone loss. This may still be an option for some women, but there is a slight increase in the risk for breast cancer. Other therapies include medications in a class called bisphosphonates. While they can increase bone mass, they do carry a risk of gastrointestinal problems. Prolonged use of bisphosphonates have been found to increase the risk

of fractures in some women. Your physician will recommend the best course of treatment for you.

Take as directed Even with the associated risks, medication is important—especially for older women who are at greatest risk for fracture because of thin bones and poor balance.

“The most important thing to do to avoid gastrointestinal issues is to take the medications as directed,” notes family medicine physician Hong Nguyen, MD, with Federal Way Medical Center. “Take the medication sitting up with a glass of water when you first wake up (before eating). Stay sitting up straight for at least half an hour after taking the medicine and don’t eat for at least an hour,” she adds.

“Taking medication with at least eight ounces of fluid is critical because this particular type of pill can get stuck in the esophagus and cause irritation,” explains family medicine physician Kevin McKeighen, DO, with Enumclaw Medical Center. “You shouldn’t just take it with a sip of water like many other pills,” he says. “IV medications and nasal sprays are new options for patients who can’t tolerate the pills,” adds Dr. McKeighen.

“However, prevention remains the best protection against osteoporosis.”

GoT QUeSTionS? Attend one of our free orthopedic health talks. Find one near you by calling 888-825-3227 or go to www.FHShealth.org/classes.

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Hong Nguyen, MD

Kevin McKeighen, DO

Ankle replacement

WD Page’s total ankle replacement was a success!

Ankle replacement

Most people know someone who has had a knee or hip replaced—but an ankle? Thanks to advanced technology, total ankle replacement (TAR) has become an appealing alternative to traditional ankle fusion surgery. For active senior WD Page, it was exactly the surgery he needed to keep him moving pain­free.

A full­time missionary known to the Russian orphans he ministers as “Grandpa Dub,” WD had been experiencing ankle pain for a couple years. “Walking was very painful, and I had a

continual limp. It certainly slowed me down.”WD was referred to Byron Hutchinson, DPM, who specializes in reconstructive

foot and ankle surgery at his clinic, Franciscan Foot & Ankle Specialists. What had begun with an ankle fracture had developed into end­stage osteoarthritis. Such severe arthritis is the result of progressive wearing down of the cartilage cushion that lines the ankle joint, ultimately resulting in bone­on­bone grinding, pain, and loss of function and mobility. While a fairly common condition, Dr. Hutchinson thought an uncommon solution might work best.

new hope for arthritic anklesUpon examination, WD was deemed a good candidate for TAR surgery. And since TAR’s average recovery time is two to two­and­a­half months compared to a staggering four to nine months for ankle fusion surgery, WD agreed it was the best option for him. “Ankle replacements have been around for over 40 years,” says Dr. Hutchinson. “What we’ve learned about biomechanics from hip and knee replacements has revolutionized this generation of ankle replacement.”

The procedure involves replacing the arthritic ankle with an implant composed of two or three parts that glide easily against each other. The ankle is therefore able to retain its natural movement painlessly.

One of the other benefi ts of TAR is that it places a smaller amount of stress upon the surrounding joints, reducing the risk for future arthritis. Fusion surgery is still recommended for younger patients with osteoarthritis, those with severe deformity of the leg, and diabetic patients.

After surgery, WD spent just four days at St. Francis Hospital, and began to move his ankle six days later. “The hardest part was waiting for the doctor to tell me I could put weight on my foot again,” he remembers. But after eight weeks, he was up and walking.

“That ankle is absolutely performing the way it’s supposed to and doesn’t cause any problems whatsoever,” says WD, happy to be back to his missionary work. “The pain is gone, and I’m back at full speed again.”

Walking on airGet active again with total ankle replacement surgery

Byron Hutchinson, DPM

www.FHShealth.org 13

TRUST THe eXPeRTSByron Hutchinson, DPM, is one of only a few surgeons in the South Sound regularly performing total ankle replacement surgery. To learn more, call Franciscan Foot & Ankle Specialists at 206-242-6553.

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health!St. Elizabeth

A publication of Franciscan Health System

St. Francis Hospital 34515 Ninth Ave S, Federal Way, WA 98003St. Joseph Medical Center 1717 South J St, Tacoma, WA 98405St. Clare Hospital 11315 Bridgeport Way SW, Lakewood, WA 98499St. Elizabeth Hospital 1455 Battersby Ave, Enumclaw, WA 98022St. Anthony Hospital 11567 Canterwood Blvd NW, Gig Harbor, WA 98332Franciscan Medical Group 1313 Broadway Plaza, Suite 200, Tacoma, WA 98402

CEO, Franciscan Health System Joe WilczekPresident, St. Elizabeth Hospital Dennis PoppManaging Editor Joan B. Artman

Franciscan Health System is part of Catholic Health Initiatives, which has health care facili-ties throughout the United States. ©2011, Franciscan Health System. All rights reserved.

For questions or comments, or if you’d like to be removed from the health! mailing list, please contact us at 253-382-3850, (fax) 253-382-3877, www.FHShealth.org or write to: Editor, Franciscan health!, Franciscan Health System, Marketing & Communications, PO Box 2197, Tacoma, WA 98401-2197.

FRANCISCAN HEALTH SYSTEM1717 South J StreetTacoma, WA 98405

St. FranciS HoSpital • St. JoSepH Medical center • St. clare HoSpital • St. elizabetH HoSpital • St. antHonY HoSpital • FranciScan Medical GroUp

About FrANCiSCAN HEAltH SyStEM

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Join in the fun!21st Annual Holiday Fantasy Gala Dinner and AuctionEnumclaw Regional Healthcare Foundation

Mark your calendar and plan to attend the 21st Holiday Fantasy Gala Dinner and Auction.

The largest fundraiser of the year, the Gala features a fabulous sit-down dinner, silent auction with over 200 wonderful items, and a live (and lively) auction where guests can bid on exciting adventures, vacation packages and many unique items. 

Holiday Fantasy is made possible by individuals and companies who gener-ously sponsor this event. Sponsorship is 100% tax deductible.

Proceeds from the Holiday Fantasy benefit St. Elizabeth Hospital (formerly Enumclaw Regional Hospital) and other health care programs in Enumclaw and surrounding communities.

Saturday, December 10, 2011 • 5:30 p.m. – 10 p.m.

For tickets, either call 360-802-3206 or order online by clicking the Holiday Fantasy link at the bottom of our website: www.enumclawrhf.org.